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MISS AMANDA M LEISURE CPNP-AC/PC
NPI 1154872653
Nurse Practitioner - Pediatrics in Fort Wayne, IN

Active since October 19, 2016PECOS Enrolled
11141 PARKVIEW PLAZA DR STE 210, FORT WAYNE, IN 46845(260) 266-5400(260) 266-5409 Get Directions Write a Review

NPPES record last updated: October 10, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 10, 2022, Jul 6, 2021, Sep 25, 2019 and 2 more (5 updates tracked since 2016).

About Miss Amanda M Leisure Cpnp-ac/pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS AMANDA M LEISURE CPNP-AC/PC (NPI 1154872653) is an individual pediatrics provider in Fort Wayne, Indiana, licensed in Indiana (71006767) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154872653
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameMISS AMANDA M LEISURECredential: CPNP-AC/PC
Location Address11141 PARKVIEW PLAZA DR STE 210Fort Wayne, IN 46845-1714
Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701
Phone(260) 266-5400
Fax(260) 266-5409
Sole ProprietorNo
Enumeration DateOctober 19, 2016
Last NPPES UpdateOctober 10, 20225 updates tracked since enumeration
NPPES CertifiedOctober 10, 2022
✔ NPI 1154872653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in IN · 71006767
11141 PARKVIEW PLAZA DR STE 210, Fort Wayne, IN 46845
Open in Google Maps ↗

Other Names 1

Former Name (1)Amanda M Wagner

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Amanda M Leisure Cpnp-ac/pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46845 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAYANNE SCHULTIS RDN
Dietitian, Registered
11141 PARKVIEW PLAZA DR STE 210
FORT WAYNE, IN 46845
Allen County (260) 266-9581
GINA CORONATO
Speech-Language Pathologist
11141 PARKVIEW PLAZA DR STE 210
FORT WAYNE, IN 46845
Allen County (260) 266-5400
DUSTIN DILLER
Nurse Practitioner
11141 PARKVIEW PLAZA DR STE 210
FORT WAYNE, IN 46845
Allen County (260) 266-5400
LAURA JEAN LEINS LMHC
Counselor (Mental Health)
11141 PARKVIEW PLAZA DR STE 210
FORT WAYNE, IN 46845
Allen County (260) 266-5400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amanda Leisure's NPI number?

The NPI number for Amanda Leisure is 1154872653. It was assigned to this individual provider in the NPPES registry on October 19, 2016. The provider is also known as Amanda M Wagner.

Where is Amanda Leisure located?

Amanda Leisure practices at 11141 Parkview Plaza Dr Ste 210, Fort Wayne, IN 46845. The listed phone number is (260) 266-5400.

What is Amanda Leisure's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Amanda Leisure enrolled in Medicare?

Yes. Amanda Leisure is registered in the Medicare PECOS enrollment system.

What insurance does Amanda Leisure accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Amanda Leisure as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Amanda Leisure was last updated on October 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.